.flucloxacillin should not be used in patients with a
history of hepatic dysfunction associated with
flucloxacillin
.flucloxacillin should be used with caution in patients
with hepatic impairment
.careful enquiry should be made about hypersensitivity
reactions to beta-lactam antibacterialslCAUTIONS
▶With intravenous useAccumulation of electrolytes can occur
with high doses.risk of kernicterus in jaundiced neonates
when high doses given parenterally
lINTERACTIONS→Appendix 1 : penicillins
lSIDE-EFFECTS
GENERAL SIDE-EFFECTS
▶Rare or very rareArthralgia.fever
SPECIFIC SIDE-EFFECTS
▶Common or very common
▶With oral useGastrointestinal disorder
▶Uncommon
▶With oral usePurpura
▶Rare or very rare
▶With oral useEosinophilia.myalgia
▶Frequency not known
▶With parenteral useAcute generalised exanthematous
pustulosis (AGEP).bronchospasm.bullous pemphigoid.
coma.dyspnoea.electrolyte imbalance.erythema
nodosum.hallucination.Jarisch-Herxheimer reaction.
nephropathy.neurotoxicity.oral candidiasis.platelet
dysfunction.purpura non-thrombocytopenic.vasculitis
lPREGNANCYNot known to be harmful.
lBREAST FEEDINGTrace amounts in milk, but appropriate
to use.
lHEPATIC IMPAIRMENTUse with caution.
lRENAL IMPAIRMENT
▶With intravenous useAccumulation of electrolytes can occur
in patients with renal failure.
Dose adjustmentsUse normal dose every 8 hours if
estimated glomerularfiltration rate less than
10 mL/minute/ 1. 73 m^2.
lEFFECT ON LABORATORY TESTSFalse-positive urinary
glucose (if tested for reducing substances).
lDIRECTIONS FOR ADMINISTRATIONForintravenous
infusion, dilute reconstituted solutioninGlucose 5 %or
Sodium Chloride 0. 9 % and give intermittently over
30 – 60 minutes.
lPATIENT AND CARER ADVICE
Medicines for Children leaflet: Flucloxacillin for bacterial
infectionswww.medicinesforchildren.org.uk/flucloxacillin-for-
bacterial-infectionslMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: infusion
Oral solution
CAUTIONARY AND ADVISORY LABELS9, 23
▶Flucloxacillin (Non-proprietary)
Flucloxacillin (as Flucloxacillin sodium) 25 mg per
1mlFlucloxacillin 125 mg/ 5 ml oral solution| 100 mlP£ 20. 99 DT
=£ 6. 93
Flucloxacillin 125 mg/ 5 ml oral solution sugar free sugar-free|
100 mlP£ 30. 08 DT = £ 23. 26
Flucloxacillin (as Flucloxacillin sodium) 50 mg per
1mlFlucloxacillin 250 mg/ 5 ml oral solution sugar free sugar-free|
100 mlP£ 36. 27 DT = £ 27. 88
Flucloxacillin 250 mg/ 5 ml oral solution| 100 mlP£ 30. 22 DT =
£ 28. 44Capsule
CAUTIONARY AND ADVISORY LABELS9, 23
▶Flucloxacillin (Non-proprietary)
Flucloxacillin (as Flucloxacillin sodium) 250 mgFlucloxacillin
250 mg capsules| 20 capsuleP£ 3. 58 | 28 capsuleP£ 5. 00
DT = £ 1. 11 | 100 capsuleP£ 3. 96 – £ 17. 80
Flucloxacillin (as Flucloxacillin sodium) 500 mgFlucloxacillin
500 mg capsules| 20 capsuleP£ 7. 50 | 28 capsuleP£ 10. 50
DT = £ 1. 94 | 100 capsuleP£ 6. 93 – £ 37. 50
Powder for solution for injection
▶Flucloxacillin (Non-proprietary)
Flucloxacillin (as Flucloxacillin sodium) 250 mgFlucloxacillin
250 mg powder for solution for injection vials| 10 vialP£ 8. 60 –
£ 12. 25
Flucloxacillin (as Flucloxacillin sodium) 500 mgFlucloxacillin
500 mg powder for solution for injection vials| 10 vialP£ 17. 20 –
£ 24. 50
Flucloxacillin (as Flucloxacillin sodium) 1 gramFlucloxacillin 1 g
powder for solution for injection vials| 10 vialP£ 34. 50 – £ 49. 00
Flucloxacillin (as Flucloxacillin sodium) 2 gramFlucloxacillin 2 g
powder for solution for injection vials| 1 vialP£ 6. 00
Combinations available:Co-fluampicil,p. 342ANTIBACTERIALS›POLYMYXINS
Colistimethate sodium 18-Dec-2016
(Colistin sulfomethate sodium)
lDRUG ACTIONThe polymyxin antibiotic, colistimethate
sodium (colistin sulfomethate sodium), is active against
Gram-negative organisms includingPseudomonas
aeruginosa,Acinetobacter baumanii, andKlebsiella
pneumoniae. It is not absorbed by mouth and thus needs to
be given by injection for a systemic effect.lINDICATIONS AND DOSE
Gram-negative infections resistant to other
antibacterials, including those caused byPseudomonas
aeruginosa,Acinetobacter baumaniiandKlebsiella
pneumoniae
▶BY SLOW INTRAVENOUS INJECTION, OR BY INTRAVENOUS
INFUSION
▶Child (body-weight up to 60 kg):50 000–75 000units/kg
daily in 3 divided doses, to be administered into a
totally implantable venous access device when giving
via slow intravenous injection
▶Child (body-weight 60 kg and above): 1 – 2 million units
3 times a day, to be administered into a totally
implantable venous access device when giving via slow
intravenous injection; maximum 6 million units per
day
Adjunct to standard antibacterial therapy for
Pseudomonas aeruginosainfection in cystic fibrosis
▶BY INHALATION OF NEBULISED SOLUTION
▶Child 1 month–1 year: 0. 5 – 1 million units twice daily,
adjusted according to response, increased to 1 million
units 3 times daily for subsequent respiratory isolates
ofPseudomonas aeruginosa
▶Child 2–17 years: 1 – 2 million units twice daily, adjusted
according to response, increased to 2 million units
3 times daily for subsequent respiratory isolates of
Pseudomonas aeruginosa
▶BY INHALATION OF POWDER
▶Child 6–17 years: 1. 66 million units twice daily346 Bacterial infection BNFC 2018 – 2019
Infection5